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Gastric Emptying In Pots - Study

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Clin Auton Res. 2013 May 25. [Epub ahead of print]
Gastric emptying in postural tachycardia syndrome: a preliminary report.

Department of Neurology, Mayo Clinic, Rochester, MN, USA.


Autonomic neuropathy is widely recognized to be associated with upper gastrointestinal symptoms and abnormal (i.e., rapid or slow) gastric emptying. While patients with postural orthostatic tachycardia syndrome (POTS) may also have gastrointestinal symptoms, our understanding of gastric-emptying disturbances in POTS is very limited. The objectives of this study were to evaluate the relationship between gastric-emptying disturbances and gastrointestinal symptoms in patients with POTS.


We retrospectively reviewed the medical records of 22 well-characterized patients with POTS and upper gastrointestinal symptoms in whom autonomic (i.e., postganglionic sudomotor, cardiovagal, and adrenergic) functions and gastric emptying were evaluated using standardized techniques and scintigraphy, respectively. Medical records were reviewed retrospectively to assess clinical features, gastric emptying, and autonomic functions.


Over 70 % of patients had nausea and/or vomiting, which was the most common GI symptom; other common symptoms were abdominal pain (59 %), bloating (55 %), and postprandial fullness/early satiety (46 %). Over one-third of patients had abnormal [i.e., rapid (27 %) or delayed (9 %)] gastric emptying. Gastric-emptying disturbances were not significantly associated with GI symptoms, autonomic symptoms or autonomic dysfunction.


Over one-third of patients with POTS and gastrointestinal symptoms have abnormal, more frequently rapid than delayed gastric emptying. These findings need to be confirmed in a larger cohort of patients.

PMID: 23708963
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I had a gastric emptying study done at Mayo. That particular day, of course my stomach was fine. Since I already was on Reglan, the doctors gave the typical recommendation of eating small meals and not drinking with meals.

Despite this test, I know sometimes I suffer from gastroparesis (slow stomach emptying) because sometimes when I throw up, food that should be long gone is still in my stomach as evidenced by what I see in the toilet. (sorry if TMI). Interestingly, a gastro I later went to said gastroparesis can come and go depending on if I am in a flare up or not. Just because one test didn't find it doesn't mean I never have it.

Preventative measure I take with my gastroparesis is taking a good digestive enzyme with heavier or more difficult to digest meals. I take a probiotic daily which helps me, but I know some feel terrible with probiotics. I also take a ginger supplement I got at Walmart at the first sign of stomach upset. If all else fails, Reglan helps me quite a bit as it helps your stomach empty more quickly.

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